Controlled Substances Practice Test

A 43-year-old female presents to pick up new prescriptions from an urgent care visit for acute dental pain after extraction. She is currently taking clonazepam (Schedule IV) 1 mg by mouth twice daily, sertraline 100 mg by mouth daily, and zolpidem (Schedule IV) 10 mg by mouth at bedtime as needed (uses most nights). Allergies: hydrocodone (itching). Medical history: generalized anxiety disorder, insomnia. Labs: serum creatinine 0.8 mg/dL (0.6–1.3), AST 22 U/L (10–40), ALT 19 U/L (7–56). New prescription: tramadol (Schedule IV) 50 mg by mouth every 6 hours as needed for pain, #20. What is the best recommendation for this patient's therapy?

A 33-year-old female (weight 59 kg) is taking lorazepam (Schedule IV) 1 mg at bedtime for 6 months for insomnia and wants to stop because she is pregnant (8 weeks). Current medications: lorazepam as above and prenatal vitamin. Allergies: none. Medical history: insomnia, generalized anxiety disorder; no substance use disorder. Labs: not available. Which controlled substance management action is most appropriate for this patient?